SHAWN WALL

WAGONER, OK
NPI1649691908
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2014-01-03
Last Update Date2014-01-03
Business Address
-- SHAWN WALL
68470 S 315 RD
WAGONER, OK 74467-6292
Phone number: 918-729-9397
Mailing Address
-- SHAWN WALL
68470 S 315 RD
WAGONER, OK 74467-6292
Phone number: 918-729-9397
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